Provider Demographics
NPI:1376535005
Name:MASTER, KIRON S (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRON
Middle Name:S
Last Name:MASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 PUESTA DEL SOL LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4871
Mailing Address - Country:US
Mailing Address - Phone:315-490-7747
Mailing Address - Fax:
Practice Address - Street 1:4150 CAMINO COYOTE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:315-490-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL30102085R0202X
TXH307132085R0202X
NMMD2008-02632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX300132569OtherRR MEDICARE
TX8G4872OtherBCBS
TX154502201Medicaid
H30713Medicare UPIN
TX154502201Medicaid